Utility of Red Blood Cell Parameters and Indices of Iron Homeostasis in Evaluation of Microcytosis without Anemia or with Mild Anemia: A Diagnostic Accuracy Study

Abstract Introduction Asymptomatic microcytosis may be a prelude to microcytic hypochromic anemia of varied causes. Evaluation red cell indices help delineate cases needing further investigation like hemoglobin high-performance liquid chromatography (Hb-HPLC). In addition, markers iron homeostasis will confirm iron-deficient erythropoiesis (IDE)/iron deficiency (IDA). Materials and Methods This was single institutional hospital-based study over period 18 months. The sample size 60, which include all age groups, males females, values mean corpuscular volume (MCV) < 80 fL, Hb ≥ 10g/dL were taken as the inclusion criteria. Various derived indices, Hb-HPLC, parameters assessed. Hb-HPLC serum ferritin with transferrin saturation (TSAT) gold standard for diagnosis hemoglobinopathies/thalassemia trait IDA/IDE, respectively. Results Out 60 samples, 24 (40%) 36 (60%) had abnormal normal proportion variants, total, seven evaluated, included Mentzer's index, distribution width Ehsani's Sirdah's formula, Matos–Carvalho Shine Lal Sehgal's index. index showed better sensitivity (89%) specificity (73%) diagnosing pure thalassemia trait. Sirdah (78%) (42%) in IDE/IDA. Ferritin (74%) (84%) IDA TSAT results IDA/IDE. Conclusion Mentzer can used screening tools detect subjects who require appropriate follow-up confirmation by Hb-HPLC. Serum remains IDA.